Exposure to intimate partner violence (IPV) can disrupt and impair children’s early development. Some evidence suggests that early care and education (ECE) participation may buffer some of these negative influences, but this area remains understudied. The current study draws on primary data from in-depth, semi-structured interviews with 17 IPV survivor mothers of young children and 6 ECE providers in New England to examine the ECE needs of children exposed to IPV and the supportive factors within ECE settings that can promote their resilience. Findings revealed that children’s IPV exposure tended to increase their needs from ECE providers and settings, and that ECE providers’ awareness of children’s IPV exposure and adequate understanding of IPV dynamics were important for supporting these needs. Participants reported key resilience-promoting features within ECE settings for children exposed to IPV: 1) risk focused factors, such as reduced exposure to IPV and prevention of IPV perpetrators’ unsafe contact with children, 2) resource-focused factors, including nurturance, stability, and facilitated access to therapeutic services, and 3) process-focused factors, including scaffolded opportunities to strengthen emotion regulation and social development. Results highlight the important role of high quality ECE for young children exposed to IPV and suggest its potential for promoting their resilience.

Active-duty military fathers are frequently away from their families throughout their military career and are faced with readjusting to family and garrison life after each separation. For fathers of very young children, reintegration can have unique challenges due to the tremendous developmental progression occurring in early childhood and the impact of lengthy deployment separations. While much of the research on military families focuses on extreme negative experiences (e.g., reactions to war injuries and posttraumatic stress disorder), little is known about the common experiences of military families. This qualitative study explores the reintegration experiences of 15 active-duty U.S. Army fathers with a child under six in their home during the deployment. Homecoming experiences were coded and analyzed to distinguish four adjustment factors and five adaptation challenges. Most fathers described having mixed experiences during reintegration, with 93% referencing at least one factor making adjustment easier (e.g., communication with their spouse during deployment), and 80% referencing at least one factor making adjustment difficult (e.g., child’s initial hesitation or perceived rejection). Adjustment facilitators included: spending quality time with family, individual and family growth, quality communication during deployment, and the service member’s parental perspective taking. Challenges to adjustment included negative postdeployment reactions of children, difficulty readjusting to family and civilian life, and service member psychological changes. These findings expand our understanding of the reintegration experience of active-duty fathers with young children and identify common challenges and facilitators that can be addressed through culturally informed supportive services across the deployment cycle.

Introduction Difficulty controlling anger is a common postdeployment problem in military personnel. Chronic and unregulated anger can lead to inappropriate aggression and is associated with behavioral health, legal, employment, and relationship problems for military service members. Military-related betrayal (e.g., military sexual assault, insider attacks) is experienced by over a quarter of combat service members and is associated with chronic anger and aggression. The high level of physical risk involved in military deployments make interconnectedness and trust in the military organization of utmost importance for survival during missions. While this has many protective functions, it also creates a vulnerability to experiencing military-related betrayal. Betrayal is related to chronic anger and aggression. Individuals with betrayal-related injuries express overgeneralized anger, irritability, blaming others, expectations of injustice, inability to forgive others, and ruminations of revenge. Current approaches to treating anger and aggression in military populations are inadequate. Standard anger treatment is not trauma-informed and does not consider the unique cultural context of anger and aggression in military populations, therefore is not well suited for anger stemming from military-related betrayal. While trauma-informed interventions targeting anger for military personnel exist, anger outcomes are mixed, and aggression and interpersonal functioning outcomes are poor. Also, these anger interventions are designed for patients with posttraumatic stress disorder. However, not all military-related betrayal meets the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-5 definition of trauma, though it may still lead to chronic anger and aggression. As a result, these patients lack access to treatment that appropriately targets the function of their anger and aggression.Materials and Methods This manuscript describes rationale, design, and methodology of a pilot clinical trial examining Countering Chronic Anger and Aggression Related to Trauma and Transgressions (CART). CART is a transdiagnostic, transgression-focused intervention for military personnel who have experienced military-related betrayal, targeting chronic anger and aggression, and improving interpersonal relationships. The pilot study will use an interrupted timeseries design, where participants are randomized to a 2-, 3-, or 4-week minimal contact waitlist before starting treatment. This design maximizes the sample size so that all participants receive the treatment and act as their own control, while maintaining a robust design via stepped randomization. This trial aims to (1) test the acceptability and feasibility of CART, (2) test whether CART reduces anger and aggression in military personnel with a history of military-related betrayal, and (3) test whether CART improves interpersonal functioning.Results The primary feasibility outcome will be the successful recruitment, enrollment, and initiation of 40 participants. Primary outcome measures include the Client Satisfaction Survey-8, the State Trait Anger Expression Inventory-2, Overt Aggression Scale-Modified, and the Inventory of Interpersonal Problems-Short Version.Conclusion If outcomes show feasibility, acceptability, and initial effectiveness, CART will demonstrate a culturally relevant treatment for chronic anger, the most frequent postdeployment problem, in a sample of active duty service members who have suffered a military betrayal. The DoD will also have an evidence-based treatment option focusing on interpersonal functioning, including relationships within the military and within families.

There is acknowledgment that deployments can be stressful for military spouses; however, less is known about their experiences post-deployment. This qualitative study examined the post-deployment experiences of 16 female spouses, whose active duty Army husband had returned from deployment within the previous 2 years and who had a young child during the deployment. Spouses reported that the time surrounding their husbands’ return was one of the great transitions, often accompanied by stress. Most families were able to work through challenges and show positive adjustment over time. However, some spouses described severe post-deployment challenges marked by disconnect from their partners; three of these were spouses whose husbands had posttraumatic stress disorder. The findings address how spouses prepared for their husband’s return, their reunion experiences, the process of reintegrating their husband into family life, and individual changes in the partners post-deployment. Facilitators and challenges to adjustment were identified as potential targets for interventions.

The STRONG STAR Consortium (South Texas Research Organizational Network Guiding Studies on Trauma and Resilience) and the Consortium to Alleviate PTSD are interdisciplinary and multi-institutional research consortia focused on the detection, diagnosis, prevention, and treatment of combat-related posttraumatic stress disorder (PTSD) and comorbid conditions in military personnel and veterans. This manuscript outlines the consortia's state-of-the-science collaborative research model and how this can be used as a roadmap for future trauma related research. STRONG STAR was initially funded for 5 years in 2008 by the U.S. Department of Defense's (DoD) Psychological Health and Traumatic Brain Injury Research Program. Since the initial funding of STRONG STAR, almost 50 additional peer-reviewed STRONG STAR-affiliated projects have been funded through the DoD, the U.S. Department of Veterans Affairs (VA), the National Institutes of Health, and private organizations. In 2013, STRONG STAR investigators partnered with the VA's National Center for PTSD and were selected for joint DoD/VA funding to establish the Consortium to Alleviate PTSD. STRONG STAR and the Consortium to Alleviate PTSD have assembled a critical mass of investigators and institutions with the synergy required to make major scientific and public health advances in the prevention and treatment of combat PTSD and related conditions. This manuscript provides an overview of the establishment of these two research consortia, including their history, vision, mission, goals, and accomplishments. Comprehensive tables provide descriptions of over 70 projects supported by the consortia. Examples are provided of collaborations among over 50 worldwide aca-demic research institutions and over 150 investigators.

Little research regarding the influence of parental knowledge and attitudes about child development on parenting practices includes fathers. The wartime military provides a specific context for fathering with frequent separations, which may impact soldiers' knowledge and attitudes about their young children's development. The purpose of the current study is to explore how military fathers' knowledge and attitudes about their young children's development influence their parenting behaviors across the deployment cycle. Fifteen active duty U.S. Army fathers with young children completed qualitative interviews, which were coded and analyzed to identify major themes. Many fathers had accurate knowledge of typical development and adapted their parenting responsively. Some knew less and were unsure how to respond to their children's behavior. Many believed separations did not negatively affect young children. This attitude may reduce concern about deployment's impact and keep these fathers mission-focused, but may also lead to missed opportunities to prepare young children for transitions. Overall, these fathers wanted to be involved, responsive parents. While many faced challenges navigating parenting throughout the deployment cycle, nearly all described positive adaptation, often with support from the homefront parent. These findings suggest that efforts to enhance military fathers' knowledge should be tied to their children's developmental stages and needs, focusing on parenting within the military context. Practitioners can respect Army families' cultural values by aligning family readiness as necessary to mission readiness.

The post-9/11 conflicts have taken a substantial toll on military families. Although positive effects of reintegration-focused programs are well-documented for service members, less is known about military spouses who are parents of young children. This article examines the outcomes of a formal reflective parenting program developed for military families who have very young children, and whether aspects of informal social support moderate spouse outcomes of anxiety, depression, and parenting stress. Data are drawn from a randomized, clinical trial (RCT) of 103 military families with children ages birth to 5 years of age. Structural equation models examined the main effects of the program and the relationship of 3 social support dimensions (perceived support, social connectedness and dyadic satisfaction) to program outcomes of interest. Analyses revealed a statistically significant reduction in anxiety in the treatment group, with a small effect size. No significant program effects emerged on parenting stress or depression. None of the social support dimensions was significantly associated with outcomes of interest. The interaction of dyadic support and treatment showed a significant moderate effect on parenting stress. Spouses with lower baseline satisfaction who were assigned to the treatment condition reported similar levels of parenting stress at baseline and posttest, whereas their counterparts in the waitlist condition reported significantly higher parenting stress at posttest compared with baseline. Findings suggest a targeted approach to preventive intervention for military spouses who are mothers of young children. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The adverse effects of deployment-related stress (DRS) on military service members, spouses, and children are well documented. Findings from a recent Consensus Report on Military Families by the National Academies of Science, Engineering, and Medicine (2019) underscore the priority of gaining a more comprehensive understanding of the diversity of today's military families and their needs and well-being. While social support is generally regarded as helpful during times of stress, it has not been studied extensively in National Guard/Reserve spouses who are parents of young children. This qualitative study of 30 women examines the unique ways in which DRS affects women who are National Guard/Reserve spouses and mothers of young children, as well as the processes through which they encountered support to manage these stressors. Salient themes spanned experiences involving deployment cycle phases of separation and reintegration and included both anticipated and unanticipated changes in family-related division of labor, dynamics, and communication patterns. These were complicated by geographic, social, and cultural isolation and misguided efforts to support spouses initiated by civilians. Women managed these stressors primarily through seeking, acquiring, and repurposing existing sources of informal social support for themselves and formal supports for their children, with varying degrees of success.

Spouses of National Guard/Reserve (NG/R) military service members cope with deployment-related stressors (DRS) that may contribute to increased psychological distress. Research indicates that higher levels of social support are associated with reduced depression and anxiety in military spouses, but longitudinal relationships have not yet been examined bidirectionally. This study examines temporal relationships between 3 dimensions of social support (social connectedness, dyadic satisfaction, and perceived support), and psychological distress in a sample of NG/R spouses during the first year after a service member returns from deployment. Data from 103 military spouses were drawn from a larger intervention development study. Autoregressive cross-lagged panel analyses examined the stress-buffering and support erosion hypotheses over a 3-month period. DRS were measured by the cumulative number of deployments and duration of most recent deployment. Distress was assessed using latent variables of depression and anxiety. Statistically significant relationships emerged between initial levels of psychological distress and social connectedness at 3 months. Social support dimensions of dyadic satisfaction and perceived support did not predict subsequent levels of psychological distress. No significant relationships emerged between any dimension of social support at baseline and either form of psychological distress at 3 months. The support erosion hypothesis may more accurately describe the relationship between social support and psychological distress in this sample than the stress-buffering mechanism. During the first year of reintegration, social connectedness may be of particular relevance for NG/R spouses, as they may not have access to supports typically available to their active duty counterparts. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Previous studies have investigated the impact of secondary exposure to intimate partner violence (IPV) work victim advocates, but there is a lack of research examining the specific effect of intimate partner homicide (IPH). Given the sudden and final nature of IPH, it is possible that its effect on advocates differs from the daily exposure to IPV and could require different organizational responses. This study examined how agency climate and interventions contributed to advocate adjustment after IPH. Organizational responses can prevent burnout, the loss of practice wisdom, and the future delivery of inadequate services. Nine advocates were recruited from a rural New England state and interviewed about their perceptions of organizational interventions after IPH. Advocate interviews were analyzed using narrative and thematic approaches to explore how advocates talked about IPH and types of interventions they received. The approaches' findings were examined in tandem to describe advocate perceptions of organizational responses after IPH. Findings centered on three main themes: a need for connection among advocates due to isolation from the community, a need for the acknowledgment of the gravity of IPH, and a need for flexible, clear policies. In conjunction with the extant literature, study findings suggested a three-pronged approach to agency responses to IPH: prepare advocates, support advocates, and connect advocates. Stressors and program responses specific to the rural context are additionally discussed. It is imperative for advocacy organizations to support their employees to maintain agency health and continue to provide effective services to vulnerable members of their communities after IPH.

Parenting very young children in the context of military service, deployment separations, and war-related trauma can be challenging for many families. Female active duty personnel represent one of the fastest growing segments of the military, and recent policy changes have led women to pursue serving in combat positions at much higher rates. While not much is known about service member mothers, some studies have shown that they experience significant symptoms of distress, depression, and anxiety during the deployment cycle, feelings of disconnection from family during reintegration, and higher rates of childhood trauma histories than their male counterparts. Service member mothers who experience the combined stressors of deployment separation, combat exposure, and adverse childhood experiences-a triple threat-may be at serious risk of posttraumatic stress and depressive symptomatology, which can negatively influence the quality and nature of their parenting and parent-child relationships. This case report describes the participation of a young single service member mother and her preschool-aged daughter in a home-based, reintegration program designed for military families with very young children (ages 0-5). The paper illustrates how this relationship-based, reflective parenting intervention was effective in increasing the mother's sense of competence in her parenting and strengthening the parent-child relationship.

Background: Postpartum depression (PPD) is understudied in military populations. The present descriptive transversal study evaluated the incidence of PPD diagnoses in U.S. military electronic health records, based on International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 codes, among active duty military servicewomen between 2001 and 2018. Methods: Data on 3,724 active duty military servicewomen who served between 2001 and 2018 were drawn from the Defense Medical Epidemiological Database and stratified by race, age, marital status, service branch, and military pay grade. Single sample chi squares were used to examine observed versus expected differences in diagnosis rates. Results: The incidence rate of PPD among all U.S. military servicewomen was the lowest in 2001 (1.96 per 1,000) and the highest in 2018 (29.95 per 1,000). Servicewomen most often diagnosed with PPD were white (60%), married (74%), in the enlisted pay grades of E-1 to E-4 (60%), in the Army (43%), and were between 20 and 24 years old (46%). Statistically significant differences (p < 0.001) were found between observed and expected counts across all five demographic variables. Conclusions: This is the first population-based study to assess the incidence rates of PPD among all active duty military servicewomen. Findings that some groups were over- and underdiagnosed within each demographic category, and that PPD incidence rates have increased between 2001 and 2018, underscore the importance of further research to inform policies and interventions supporting this vulnerable population.

Family stress theory explains how demands placed on the family system interact with capabilities to influence family adaptation. One capability that some military families may use naturalistically is that of benefit-finding, the recognition of value and benefit after a stressful or traumatic experience. In this mixed methods study, authors explore the perception of benefits associated with military service amongst 26 home-front mothers. Methods incorporate a self-report questionnaire adapted for this population and a qualitative interview aimed at understanding challenges and benefits associated with these women's experiences as members of a military family. Results revealed that more women than not endorsed meaningful changes that they have experienced as a result of their family's military service, despite a wide range of challenges and negative experiences. Four themes of benefits emerged from analyses: (a) financial, educational and career benefits; (b) cultivating strength; (c) friendships and community; and (d) pride. These findings illuminate the diverse ways in which women find meaning in their family's military service and upon replication and elaboration of these results, have clinical implications for the development of future prevention and intervention work with military families.

Family involvement in the treatment of posttraumatic stress disorder (PTSD) among veterans has the potential to improve treatment retention and outcomes. Current protocols that incorporate family members into treatment tend to involve at least 15 sessions, and none are designed to complement Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE), the two most widely used and heavily promoted evidence-based PTSD therapies in the Veterans Affairs (VA) healthcare system. The current paper describes the development and initial feasibility and acceptability of a Brief Family Intervention (the BFI) designed to be delivered as an adjunct to veterans' individual CPT/PE. The BFI focuses on providing psychoeducation about PTSD and treatment, building family member support for treatment, and reducing family symptom accommodation. A detailed review of the treatment structure and activities is provided, and qualitative data from four dyads (veterans and their spouses/significant others) at baseline and post-intervention are presented. Veterans and partners reported positive responses to the program and were enthusiastic about its utility. Larger randomized controlled studies will be needed to determine the protocol's efficacy and effectiveness.

Few studies have examined the experiences and perceptions of servicewoman mothers and their children, even as an increasing number of them have experienced deployment and combat exposure. The present paper describes a qualitative study that explored National Guard/Reserve (NG/R) mothers' experiences with mothering and co-parenting during reintegration and their perceived priorities, supports, challenges and needs. Interpretive phenomenological analysis of seven in-depth qualitative interviews produced themes including reunion and loneliness, the importance of time, help seeking and gendered experiences. Notably, all participants transitioned immediately back into primary caregiver roles upon homecoming, and several described how difficult it was to readjust while privately dealing with unmet mental health needs. Findings underscore the importance of a flexible suite of service options that meet key needs, most importantly, child care, social-emotional support for children and peer-based parenting support specific to servicewoman mothers. For NG/R mothers, who may live far from base, community-based services are essential, but as participants described, civilian social workers and other professionals must develop specialized knowledge, skills and experience to provide appropriate support.

The goals of this session are to characterize the functioning of active duty families with young children in the predeployment phase of the deployment cycle and to present initial findings from an ongoing randomized, controlled trial examining the efficacy of Strong Families Strong Forces, a reflective parenting program designed to reduce parenting stress and adverse child outcomes among military families experiencing deployment separation.

Contemporary service members and their partners have adapted their coparenting to respond to the specific transitions and disruptions associated with wartime deployment cycles and evolving child development. This qualitative study draws upon interviews with service member and home front parents of very young children to characterize their coparenting experiences throughout the deployment cycle. Parents described varied approaches as they considered their children’s developmental capacities, the fluidity of demands throughout deployment, and the service member’s well-being during reintegration. A common theme was the key role of home front parents in facilitating the service member–child relationship through communication and maintaining the presence of the deployed parent in the child’s everyday life. Reintegration challenges included redistribution of coparenting roles, the pacing of the service member into family roles, and concerns related to the returning parent’s distress. Study findings highlight areas of coparenting throughout the deployment cycle that can be supported though prevention and intervention efforts.

Couples form the foundation of military families. However, on average, couples become significantly less satisfied with their relationships and marriages across the deployment cycle. Reduced satisfaction places partners at risk for psychological distress and family problems. The present study examines the effects of a family based reintegration program aimed at enhancing reflective functioning in recently deployed service members and their home-front partners on relationship satisfaction. Results reveal that most dyads report being satisfied in their relationship at baseline. However, greater couple distress was related to more psychological distress in both partners. For spouses, intervention had a positive, significant effect on relationship satisfaction. Variations in relative risk for couple distress among service members and their spouses highlight the need to assess both partners to clarify risk factors and modifiable targets of intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).